Demography of the National Emergency Medical Services Workforce: A Description of Those Providing Patient Care in the Prehospital Setting

2020 ◽  
pp. 1-8
Author(s):  
Madison K. Rivard ◽  
Rebecca E. Cash ◽  
Christopher B. Mercer ◽  
Kirsten Chrzan ◽  
Ashish R. Panchal
Keyword(s):  
Patient Care ◽  
Emergency Medical Services ◽  
Prehospital Setting ◽  
Medical Services ◽  
Emergency Medical ◽  
National Emergency

It’s Time to Talk to Prehospital Providers: Feedback Disparities among Ground-Based Emergency Medical Services Providers and its Impact on Job Satisfaction

2021 ◽  
pp. 1-9
Author(s):  
Sarayna S. McGuire ◽  
Anuradha Luke ◽  
Aaron B. Klassen ◽  
Lucas A. Myers ◽  
Aidan F. Mullan ◽  
...  
Keyword(s):  
Job Satisfaction ◽  
Patient Care ◽  
Emergency Medical Services ◽  
Performance Feedback ◽  
Life Support ◽  
Clinical Care ◽  
Medical Services ◽  
The Past ◽  
Emergency Medical ◽  
Overall Job Satisfaction

Abstract Objective: Performance feedback on clinical care and patient outcomes is a cornerstone of medical education, yet it remains lacking in the prehospital environment. Research seeking to establish the quantity of feedback provided to Emergency Medical Services (EMS) has been limited and studies focused on complimentary feedback or how feedback relates to EMS job satisfaction are lacking. The objectives of this study were to measure the frequency and nature of feedback received by EMS agencies and to identify the importance of receiving feedback as it relates to EMS job satisfaction. Methods: This was an anonymous, survey-based study of twenty-nine Basic Life Support (BLS) and fifteen Advanced Life Support (ALS) agencies located in Southeastern Minnesota (USA). Descriptive statistics and Fisher exact tests were used. The study was deemed exempt by the Mayo Clinic Institutional Review Board. Results: Ninety-four responses were included from nineteen different EMS agencies, including sixty-one (64.9%) paramedics and thirty-three (35.1%) emergency medical technicians (EMTs). One-half of all respondents reported that they had not received any type of feedback in the past 30 days, while another 43.6% of respondents indicated that they had only received feedback one to three times in the same time period. Twenty (60.6%) EMTs reported receiving no feedback in the past 30 days, compared with twenty-seven (44.3%) paramedics (P = .123). Of respondents receiving feedback, 65.9% reported never or rarely receiving positive reinforcing feedback and 60.6% reported never or rarely receiving constructive criticism or feedback regarding something that did not go well with patient care or transport. The majority of respondents were dissatisfied with the quantity (86.1%) and quality (73.4%) of feedback received. An overwhelming majority (93.6%) indicated that feedback on patient care or outcomes was important in influencing their overall job satisfaction. This high importance was maintained across all demographic groups. Conclusion: Within the cohort of survey respondents, a paucity of feedback received by EMS personnel is a source of dissatisfaction for EMS providers. Feedback on patient care strongly relates to overall job satisfaction. These findings suggest system-wide opportunities for structured feedback processes, focusing upon both quality and quantity of delivered feedback, to improve both patient care and staff satisfaction.

Emergency medical services oxygen equipment: a fomite for transmission of MRSA?

2018 ◽  
pp. emermed-2018-207758
Author(s):  
Cody Vaughn Gibson
Keyword(s):  
Staphylococcus Aureus ◽  
Emergency Medical Services ◽  
Prehospital Setting ◽  
Medical Services ◽  
Cross Contamination ◽  
Nacl Solution ◽  
Emergency Medical ◽  
Storage Area ◽  
Oxygen Equipment ◽  
Patient Infection

ObjectivesThe primary purpose of this study was to determine if methicillin-resistant Staphylococcus aureus (MRSA) was present on the surface of oxygen cylinders and regulators used in the prehospital setting and secondarily to assess other surfaces for MRSA within the ambulance compartment, as a comparison.MethodsOn 17 March 2018, the surface of oxygen cylinders and regulators located in ambulances at an emergency medical services (EMS) station in North Alabama (n=9) and at an offsite oxygen cylinder storage area (n=70) were swabbed using sterile cotton-tipped applicators saturated in an 0.9% NaCl solution. These cotton-tipped applicators were then streaked across the surface of HardyCHROM MRSA plates, followed by incubation at 36°C for 24 hours. The growth of pink or magenta colonies was considered a positive indication for the presence of MRSA. The motivation for assessing oxygen cylinders at the offsite storage area was to outline the persistence of MRSA on stored oxygen cylinders.ResultsOf nine oxygen cylinders tested in the ambulances, nine had MRSA colonisation (100%). MRSA was also present on 67 of 70 oxygen cylinders (96%) tested at the offsite oxygen cylinder storage area.ConclusionOxygen cylinders appear to act as a fomite for MRSA. The development of universal disinfection protocols for oxygen equipment could help reduce the risk of patient infection due to cross-contamination.

EMS Knowledge and Skills in Rural North Carolina: A Comparison with the National EMS Education and Practice Blueprint

1996 ◽  
Vol 11 (4) ◽  
pp. 254-260 ◽  
Author(s):  
Lawrence H. Brown ◽  
Terry W. Copeland ◽  
John E. Gough ◽  
Herbert G. Garrison ◽  
Kathleen A. Dunn
Keyword(s):  
North Carolina ◽  
Emergency Medical Services ◽  
Medical Services ◽  
Similar Action ◽  
Knowledge And Skills ◽  
Emergency Medical ◽  
State And Local ◽  
Ems Education ◽  
National Emergency ◽  
Eastern North Carolina

AbstractIntroduction:Many state and local emergency medical services (EMS) systems may wish to modify provider levels and their scope of practice to align their systems with the recommendations of the National Emergency Medical Services Education and Practice Blueprint. To determine any changes that may be needed in a typical EMS system, the knowledge and skills of EMS providers in one rural area of North Carolina were compared with the knowledge and skills recommended in the National Emergency Medical Services Education and Practice Blueprint.Methods:A survey listing 175 items of patient care-oriented knowledge and skills described in the National Emergency Medical Services Education and Practice Blueprint was developed. EMS providers from five rural eastern North Carolina counties were asked to identify on the survey those items of knowledge and skills they believed they possessed. The skills and knowledge selected by the respondents at the five different North Carolina levels of certification were compared with the knowledge and skills listed for comparable provider levels delineated by the National Emergency Medical Services Education and Practice Blueprint. The proportions of the recommended skills reported to be possessed by the respondents were compared to determine which North Carolina certification levels best correlate with the Blueprint.Results:One hundred forty-five EMS providers completed the survey. The proportion of recommended skills and knowledge reported to be possessed by Emergency Medical Technicians (EMTs) ranked significantly lower than did the skills and knowledge reported to be possessed by respondents at other levels in five of the 10 Blueprint elements. The proportion of recommended skills and knowledge reported to be possessed by EMT-Defibrillator-level personnel ranked lower than did those reported to be possessed by respondents at other levels in seven of the 10 Blueprint elements. The proportion of recommended skills and knowledge reported to be possessed by EMT-Intermediates ranked lower than did those reported to be possessed by respondents at other levels in nine of the 10 Blueprint elements. The proportion of recommended skills and knowledge reported to be possessed by EMT-Advanced Intermediates ranked lower than were the skills and knowledge reported to be possessed by respondents at other levels in two of the 10 Blueprint elements. Finally, the proportion of recommended skills and knowledge reported to be possessed by EMT-Paramedics ranked lower than were those reported to be possessed by respondents at other levels in one of the 10 Blueprint elements.Conclusion:In North Carolina, combining the EMT and EMT-Defibrillator levels and eliminating the EMT-Intermediate level would create three levels of certification, which would be more consistent with levels recommended by the Blueprint. The results of this study should be considered in any effort to revise the levels of EMS certification in North Carolina and in planning the training curricula for bridging those levels. Other states may require similar action to align with the National Emergency Medical Services Education and Practice Blueprint.

Emergency Medical Services System Changes Reduce Pediatric Epinephrine Dosing Errors in the Prehospital Setting

PEDIATRICS ◽  
2006 ◽  
Vol 118 (4) ◽  
pp. 1493-1500 ◽  
Author(s):  
A. H. Kaji ◽  
M. Gausche-Hill ◽  
H. Conrad ◽  
K. D. Young ◽  
W. J. Koenig ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Prehospital Setting ◽  
Medical Services ◽  
Emergency Medical ◽  
System Changes

scholarly journals Analysis of the Adequacy of Prehospital Emergency Medical Services Use of Patients Who Visited Emergency Departments in Korea from 2016 to 2018: Data from the National Emergency Department Information System

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Sung Joon Park ◽  
Jung-Youn Kim ◽  
Young-Hoon Yoon ◽  
Eu Sun Lee ◽  
Hyun-Jin Kim ◽  
...  
Keyword(s):  
Emergency Department ◽  
Information System ◽  
Emergency Medical Services ◽  
Secondary Data ◽  
The Other ◽  
Limited Resources ◽  
Medical Services ◽  
Emergency Medical ◽  
Prehospital Emergency ◽  
National Emergency

Introduction. Proper ambulance use is important not only due to the patient’s transport quality but also because of the need for efficient use of limited resources allotted by the system. Therefore, this study was conducted to check for overuse or underuse of the ambulance system by patients who visited the emergency department (ED). Methods. In this study, a secondary data analysis was conducted using the existing database of the National Emergency Department Information System with all patients who visited EDs over the three-year study period from 2016 to 2018. The study subjects were classified into the following groups: (1) appropriate Emergency Medical Services (EMS) usage; (2) appropriate no EMS usage; (3) underuse; and (4) overuse groups. Results. Of 18,298,535 patients, 11,668,581 (63.77%) were classified under the appropriate usage group, while 6,629,954 (36.23%) were classified under the inappropriate usage group. In the appropriate EMS usage group, there were 2,408,845 (13.16%) patients. In the appropriate no EMS usage group, there were 9,259,706 (50.60%) patients. As for the inappropriate usage group, there were 5,147,352 (28.13%) patients categorized under the underuse group. On the other hand, there were 1,482,602 (8.10%) patients under the overuse group. Conclusion. There are many patients who use ambulances appropriately, but there are still many overuse and underuse. Guidelines on ambulance use are necessary for the efficient use of emergency medical resources and for the safety of patients.

ERRATUM

PEDIATRICS ◽  
1995 ◽  
Vol 96 (3) ◽  
pp. 423-423
Keyword(s):  
Emergency Medical Services ◽  
Human Services ◽  
Medical Services ◽  
Institute Of Medicine ◽  
Call To Action ◽  
Health And Human Services ◽  
Department Of Health ◽  
Emergency Medical ◽  
The Us ◽  
National Emergency

The July supplement to Pediatrics, "A Call to Action: the Institute of Medicine Report on Emergency Medical Services for Children," Jane F. Knapp, MD, Editor, was sponsored by the National Emergency Medical Services for Children Resource Alliance, through a grant from the US Department of Health and Human Services. This information was inadvertently omitted from the supplement.

911 and the area code from which you call: How to improve the disparity in California’s Emergency Medical Services

2020 ◽  
Vol 18 (3) ◽  
pp. 247-260
Author(s):  
Jeffrey A. Covitz, BS, MA, NRP ◽  
Anke Richter, PhD ◽  
Douglas J. MacKinnon, PhD
Keyword(s):  
Patient Care ◽  
Socioeconomic Factors ◽  
Emergency Medical Services ◽  
Patient Outcomes ◽  
The United States ◽  
Performance Measure ◽  
Medical Services ◽  
Measure Data ◽  
Geographical Differences ◽  
Emergency Medical

Introduction: Thirty-three separate local emergency medical services (EMS) authority agencies serve the 58 counties in California. Each local emergency medical services agency dictates widely different treatment and transport protocols for its paramedics. Although previous research has established the problem of geographic EMS disparities, nothing definitively explains their cause.Methods: We analyze California’s most recently available EMS performance-measure data to determine if there is still disparity in EMS patient care and patient outcomes in California. If there is a disparity, we determine whether the differences are accounted for by socioeconomic factors, geographical differences, or population size, by combining California EMS data with other state and county level data. If none of these factors are significantly correlated, this supports the hypothesis that something different, such as system structure, could be a potential cause of California’s EMS disparities. As a secondary analysis, we attempt to replicate these types of analyses at national and international levels, which could potentially permit a structural comparison as well.Results: There is still disparity in EMS patient care and patient outcomes in California. Regression analyses did not identify a single factor to explain the disparity in performance measures. Most notably, the regression found that basic socioeconomic factors and geographical differences frequently speculated as common drivers for disparity of services, including median income, population density, and availability of specialty care facilities, did not account for the disparity in services.Conclusions: Unfortunately, the striking lack of performance-measure data-a data desert-for EMS throughout the United States meant that the secondary analyses were inconclusive. Based on these results, we propose three recommendations:(1) most importantly, the lack of data must be addressed. Data collection should be standardized and mandatory for all EMS providers. (2) Treatment protocols for the state should be standardized and based on the latest evidence-based research. Providers should be required to offer the same level of care, to all geographic regions. (3) It may be beneficial to consider restructuring the California EMS system. While the research is limited due to imperfect information, consolidated systems seem to perform better. An existing framework for this already exists.

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